Warning: fopen(/home/virtual/colon/journal/upload/ip_log/ip_log_2025-11.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 95 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 96 The New Stapler Device Is Good, But Needs More Evaluation
Skip Navigation
Skip to contents

Ann Coloproctol : Annals of Coloproctology

OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > Ann Coloproctol > Volume 30(2); 2014 > Article
Editorial
 The New Stapler Device Is Good, But Needs More Evaluation
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology 2014;30(2):59-59.
DOI: https://doi.org/10.3393/ac.2014.30.2.59
Published online: April 25, 2014

Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.

Correspondence to: Ik Yong Kim, M.D. Department of Surgery, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 220-701, Korea. Tel: +82-33-741-0573, Fax: +82-33-744-6604, iykim@yonsei.ac.kr

© 2014 The Korean Society of Coloproctology

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

prev next
  • 3,212 Views
  • 34 Download
  • 1 Web of Science
Full Article

Download PDF Download PDF

See Article on Page [Related article:] 77-82
In colorectal surgery, safe anastomosis following complete tumor removal is an essential element. Colorectal surgeons inevitably encounter anastomosis-related complications, such as leakage, stenosis, or bleeding. Anastomosis leakage is associated with not only poorer short-term clinical outcomes, but also unfavorable oncologic outcomes [1]. In addition, anastomosis stenosis compromises the patient's quality of life.
The use of the circular stapler has facilitated sphincter-preserving surgery for sigmoid colon or rectal cancer, and the stapling technique has become popular. However, that stapler device does not always guarantee a 100% safe colo-colic or colo-rectal anastomosis. In this regard, a compression anastomosis device (Colon Anastomosis Ring-ColonRing, NiTi Surgical Solutions, Netanya, Israel) has been introduced. However, small-scale animal and human studies have shown comparable results between stapled and compression anastomosis [2]. In this issue of the Annals of Coloproctology, Kwag et al. [3] published their retrospective data. The authors evaluated the safety and efficacy of the compression anastomosis device in 67 colon cancer patients and observed that the compression anastomosis device did not increase the incidence of anastomosis-related complications. This type of study, which investigates a new surgical device, always deserves to be applauded as new techniques carry unknown risks and a learning curve. However, this study was based on a retrospective, small series and only included data on colon cancer patients. In a recent study, Kang et al. [4] evaluated a total of 20 cases of compression anastomosis (anterior resection, 11; low anterior resection, 9) and experienced one anastomosis leakage in patients with rectosigmoid colon cancer. The compression anastomosis technique needs more large-scale clinical studies and more data on rectal cancer surgery before it will be accepted.
A bad workman finds fault with his tools. For good gastrointestinal anastomosis, strict adherence to operative principles may be more important than the type of surgical device used. These principles include adequate exposure of the surgical field, the use of well-vascularized tissue, absence of tension, no fecal contamination, watertight closure, mucosal apposition and meticulous technique [5].
  • 1. Jung SH, Yu CS, Choi PW, Kim DD, Park IJ, Kim HC, et al. Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery. Dis Colon Rectum 2008;51:902–908. ArticlePubMed
  • 2. Zbar AP, Nir Y, Weizman A, Rabau M, Senagore A. Compression anastomoses in colorectal surgery: a review. Tech Coloproctol 2012;16:187–199. ArticlePubMed
  • 3. Kwag SJ, Oh ST, Kim JG, Kang WK, Lee JK. Niti CAR 27 versus a conventional end-to-end anastomosis stapler in a laparoscopic anterior resection for sigmoid colon cancer. Ann Coloproctol 2014;30:77–82.ArticlePubMedPMC
  • 4. Kang J, Park MG, Hur H, Min BS, Lee KY, Kim NK. Safety and efficacy of the NiTi Shape Memory Compression Anastomosis Ring (CAR/ColonRing) for end-to-end compression anastomosis in anterior resection or low anterior resection. Surg Innov 2013;20:164–170. ArticlePubMed
  • 5. Silberstein I, Rolandell R. Suturing, stapling, and tissue adhesives. In: Yeo CJ, editor. Shackelford's surgery of the alimentary tract. 7th ed. Philadelphia: Elsevier Inc.; 2012. p. 920–928.PubMed

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      • Cite this Article
        Cite this Article
        export Copy Download
        Close
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        The New Stapler Device Is Good, But Needs More Evaluation
        Ann Coloproctol. 2014;30(2):59-59.   Published online April 25, 2014
        DOI: https://doi.org/10.3393/ac.2014.30.2.59
        Close
      • XML DownloadXML Download
      The New Stapler Device Is Good, But Needs More Evaluation
      The New Stapler Device Is Good, But Needs More Evaluation
      Ann Coloproctol : Annals of Coloproctology Twitter Facebook
      © Korean Society of Coloproctology.
      TOP